Kendal

Researchers are conducting a multi-centre observational study to better understand giant cell arteritis GCA and polymyalgia rheumatica PMR, conditions mainly affecting people over 50 years old. The study aims to identify genetic factors that influence susceptibility to these diseases to provide new insights into how they develop. It includes both retrospective participants with confirmed diagnoses and prospective participants suspected of having these conditions, with some patients also enrolled in a registry monitoring tocilizumab treatment for relapsing or refractory GCA. The study collects detailed clinical, imaging, and molecular data, including genetic and proteomic analyses, from participants to characterize disease subtypes and impacts. Researchers also assess quality of life through patient-reported outcomes and track long-term prognosis by linking to health records. The study explores environmental factors and co-existing conditions to improve diagnosis, prognosis, and monitoring of disease activity, especially for patients receiving synthetic or biological disease-modifying anti-rheumatic drugs. Participants provide information during baseline assessments, including blood and urine samples for analysis, and complete questionnaires about their symptoms and quality of life. Follow-up occurs through health record review over an average of one year to evaluate diagnosis and disease outcomes. The primary measure is genetic susceptibility, with secondary outcomes focusing on disease characteristics, life impact, diagnosis, and disease activity. The study is sponsored by the University of Leeds and started in 2005, continuing through 2028.

This research aims to improve the accuracy of MRI scans in detecting early-stage rectal cancer and significant rectal polyps. Many patients with early rectal cancer currently undergo major surgery or unnecessary treatments due to inaccurate staging. The study evaluates a new MRI reading method called PRESERVE, which has been shown to identify early rectal cancers more accurately and may allow more patients to have less invasive local excision surgery that preserves the rectum and quality of life. The study compares two phases a control phase where patients receive standard care, and an intervention phase following training of radiologists in the PRESERVE MRI staging method. During the intervention phase, MRI scans are recommended for rectal polyps 20mm or larger or with suspicious features before removal, alongside radiologist training. Each hospital transitions from control to intervention at a randomized time, with no crossover of patients between phases. Participants will be monitored through clinical investigations before, during, and after treatment as per standard care. Researchers will assess the accuracy of tumor staging on MRI, the number of patients identified for rectal preservation surgery, and quality of life outcomes over up to 5 years. Additional measures include scan quality, tumor characteristics, treatment costs, and histopathological biomarkers. The primary outcome is the impact of radiologist training on staging accuracy measured after one year.

Idiopathic pulmonary fibrosis IPF is a progressive lung disease causing scarring that leads to coughing and breathlessness. Many IPF patients also have reflux disease, where stomach acid can damage the lungs. This research aims to find out if treating IPF patients with proton pump inhibitors PPIs, which reduce stomach acid, can slow down the progression of IPF. The trial is a randomized, placebo-controlled study involving 298 IPF patients across about 37 UK hospitals. Participants will be randomly assigned to take either lansoprazole a PPI or dummy tablets twice daily for 12 months. They will start weekly breathing tests at home using equipment provided and, if they have a cough, use a device to count coughs over 24 hours. Participants will complete questionnaires about coughing, breathlessness, sleep habits, and overall health. Some will also wear activity and sleep monitors during cough monitoring sessions. Dose reduction is allowed if side effects occur. During the study, patients will complete regular questionnaires and provide blood samples for safety checks at 3, 6, 9, and 12 months. Weekly home spirometry will continue for the full year. Researchers will track lung function, cough frequency and severity, breathlessness, quality of life, sleep quality, reflux symptoms, and hospital-free survival. Remote and in-person visits are possible, and participants will receive training on study procedures. The primary outcome is the change in lung function 12 months after starting treatment.